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General NPI Number Information
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NPI Number | 1588985428
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Entity Type | Individual
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Provider Name | MAUREEN R AGOSTI RN
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Gender | Female
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Dates
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Enumeration Date | 06/15/2010
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Last Update Date | 06/15/2010
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Provider Practice Location Address
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Address Line | 140 OLD ORANGEBURG RD BUILDING 57 8TH FLOOR NURSING
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City | ORANGEBURG
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State | NY
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Zip | 10962-1157
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Country | US
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Telephone | 845-680-8078
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Fax |
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Provider Business Mailing Address
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Address Line | 140 OLD ORANGEBURG RD BUILDING 57 8TH FLOOR NURSING
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City | ORANGEBURG
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State | NY
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Zip | 10962-1157
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Country | US
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Telephone | 845-680-8078
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 220859
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 220859
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License Number State | NY
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